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Tuesday, May 7, 2013

If Ovaries Could Speak

It was dark and foggy. No moon. No stars. The air had a misty tang to it and his footsteps echoed faintly as he paced himself, staying close to the walls, avoiding the beams of light from the streetlights. He tugged at the dangling drawstrings, with a gloved left hand, pulling the soft fleece snugly over his ears and hiding his profile in the black hole of his hooded sweatshirt. The young woman's silhouette, framed in the well lit window, was visible from the street. Her willowy arms moved animatedly. She appeared to be speaking on the phone. She was definitely alone in the house. As he approached, he could hear her voice traveling towards him from an open window; the way in. He slipped the heavy metal cylinder from his pocket and secured it into place and slipped soundlessly through the open window. Moments later, a muted shot, and she was gone. Forever. Another hit by the "Silent Killer".

Give me a break. There's no such thing as a "Silent Killer"... Well, maybe in the movies or on TV or written into a riveting mystery novel but not in Real Life and certainly not of the cancer variety. Ovarian cancer is often referred to as a "silent killer" and since May 8th is the first World Ovarian Cancer Day, I'm dedicating this post to raising awareness about ovarian cancer, the gynecologic cancer with the lowest survival rate. On this day, ovarian cancer
awareness organizations from across the world will aim to have a singular focus and message
for ovarian cancer and its symptoms. Ovarian cancer is NOT a silent killer and many groups have taken to calling it "the disease that whispers".

According to, OvarianCancerDay.org, ovarian cancer is diagnosed annually in nearly a quarter of a million
women globally, and is responsible for 140,000 deaths each year. Statistics show that just 45% of women with ovarian cancer are likely
to survive for five years compared to up to 89% of women with breast
cancer. Those are some pretty miserable statistics. And what's the deal with the silence and the whispering? As a woman, I can say proudly and with confidence that I'm on pretty good terms with myself. In tuned. In touch with my body. I know when I don't feel well and I definitely noticed when my ovaries started "whispering" to me. The only thing is, I couldn't quite pinpoint where the "whispering" was coming from and what it meant. As I've written about before, I knew something was wrong for many months and I visited many doctors. No one identified or connected all the "whispering" symptoms as any kind of imminent threat to my health let alone my life or cancer. So lets be clear about ovarian cancer, it's NOT a silent killer unless you ignore what your ovaries are trying to tell you. The signs and symptoms are subtle. Learn them. Maybe you will save someone's life, or your own. More importantly, take this moment to internalize this: be your own advocate. If something is wrong and you KNOW something is wrong, don't give up. Not everything shows up on a routine blood test. Listen to your body. Get it checked. If going to the gynecologist for your annual check-up gives you butterflies or having your breasts examined makes you squeamish or the thought of a camera snaking through your colon makes you put off sharing your symptoms with a doctor... imagine the regret you'll feel (G-d forbid) discovering advanced stage cancer has invaded your body.

So, what are the signs?
According to cancer.org, recent medical studies show symptoms often do exist for ovarian
cancer, even in its early stages. The most common include: bloating pelvic or abdominal pain trouble eating or feeling full quickly urinary symptoms, such as the need to go urgently or frequentlynauseafatigue that doesn't get better with restirregular cycleirregular bleeding
Trouble
is, these symptoms are relatively common and associated with a number
of different health problems, from irritable bowel syndrome to urinary
tract infections. They are more likely to be due to other, less serious
problems. But if you have these symptoms almost daily for more than a few weeks, report them to your doctor right away. When
ovarian cancer is found early, while it is still confined to the ovary,
about 93% of patients live longer than 5 years after diagnosis. Unfortunately, only about 20% of ovarian cancers are found at this early
stage.
See a doctor if you have persistent symptoms like the
ones described above, and get regular women’s health exams. While most
early ovarian tumors are difficult for even the most skilled doctor to
feel during a pelvic exam, an exam may help identify other cancers or
gynecologic conditions.

Get in touch with your family... know your history. World wide, 10-15% of ovarian cancer cases are caused by genetic mutations and in the Ashkenazi Jewish population, those numbers are astoundingly higher. Lifetime risk estimates for ovarian cancer for women in the general
population are about 1.4% compared with 15% to 40% of women who have a harmful BRCA1 or BRCA2 mutation. Genetic mutations that can cause breast, ovarian, and other cancers can be passed from mothers AND fathers to both daughters and sons. Women with a mutated BRCA1 or
BRCA2 gene have a lifetime risk of between 36% - 85% of
developing breast cancer by age 70! The ethical debate over whether to-test-or-not-to-test are rampant. With the main preventative option for ovarian cancer being prophylactic risk-reducing salpingo-oophorectomy (removal of healthy fallopian tubes and ovaries), let's just say it's not a very appealing or attractive option. As of May 8th, 2013, doctors and scientists have yet to discover or develop viable tests, tools, or magic balls to adequately detect or screen for early stage ovarian cancer. Likewise, treatment options are limited. So, yes, if you want my personal opinion, I say wipe the sand out of your eyes and get genetic counseling. Get the guidance you want and need from an experienced and well-trained genetic counselor who can help you make your choice about genetic testing, surveillance, and prevention of genetic cancers.

Back to that, "Silent Killer", the one with the gun and the silencer... you know you're going to lock your windows and doors tonight before you go to bed. Forget the killer... surely you have homeowners insurance? Car insurance? Health insurance? The best locks and coverage you're ever going to get is taking your health into your own hands. Listen to your body and trust your inner voice. Eat healthy, exercise, stay proactive about your own health, and don't put off those not-so-fun recommended medical check-ups... oh, and choose happiness. The rest is all in G-d's hands.